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15 January 2020

Association between chronic periodontitis and oral H. pylori: a meta-analysis

Lara Figini

Chronic periodontitis  (CP) accounts for 95% of PD caused by microorganism infection and aetiology with local irritation.
Most CP patients are adults, and the prevalence rate dramatically increases after 35 years of age. The microorganisms in dental plaques and their products such as hydrogen peroxide are risk factors for CP.
Numerous studies have shown that the presence of H. pylori is strongly associated with chronic gastritis and duodenal ulcers, and that the microorganisms present in oral plaque and in saliva play a potential role for H. pylori. Several studies in the literature suggest that H. pylori in oral plaque is a high risk factor for recurrent gastric infection.

But can the presence of H. pylori in oral plaque be a risk factor for chronic periodontitis? 
In a review, published on Plos one, December 2019, the authors performed a meta-analysis of articles published in the literature on the correlation between oral H. pylori and CP and try to answer to this question.

Materials and Methods
To perform this meta-analysis, they searched papers published from 2000 to 2018 on PubMed, OVID, Springer Link, Chinese National Knowledge Infrastructure (CNKI) and Chinese Biology Medicine search engines. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for the correlation between H. pylori and CP were estimated. Heterogeneity, publication bias and subgroup analyses were also conducted.  

A total of 918 papers on oral H. pylori and CP were collected, and 11 papers were in accordance with the inclusion criteria.
Oral H. pylori was suggested to be correlated with CP. The results indicated that a H. pylori-positive state significantly increased the risk of CP 3.42 times (OR = 3.42; 95% CI = 2.71–4.31). A diagnostic test using polymerase chain reaction (PCR) showed a higher prevalence of H. pylori (OR = 3.70; 95% CI = 2.66–5.14) than did that using the rapid urease test (RUT) (OR = 3.13; 95% CI = 2.26–4.34).  

From the data of this meta-analysis, which must be confirmed in other similar reviews, it can be concluded that chronic periodontitis (CP) is potentially correlated with oral H. pylori in adults and that oral H. pylori may be a possible factor of risk for CP.    
Clinical implications  
H. pylori infection is a common gastrointestinal infection that can cause pathological effects, increase oxidative stress and induce inflammatory responses. Interest in H. oral pylori is increased rapidly, as the presence of this bacterium in the oral ambient is often associated with chronic periodontitis.     

For additional informations: The association between chronic periodontitis and oral Helicobacter pylori: A meta-analysis.

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